153 E 87 ST, Cnr. Lexington Av. Suite 1B. New York Patient Portal Facebook Twitter Instagram Yelp Youtube UESKD

Patient Forms

Our Forms

Your first visit to our office is designed to get you better acquainted with all we offer, as well as introduce you to Dr. Vaysman, Dr. Basir, Dr. Jahn’Shahi, and our caring staff.

We encourage questions, and do our best to always deliver quality care. Please take a moment prior to your scheduled appointment to download our patient forms. We ask that you complete the forms and bring them with you to your appointment so we may better assist you in a timely manner.

Thank you for your confidence in our office, we look forward to assisting you with all your orthodontic needs.

Adult History Form
Child History Form
Notice of Privacy Practice